Article

OBJECTIVES: (1) To evaluate the reliability of ultrasonographic measures of the
acromiohumeral distance (AHD) in shoulder positions linked to wheelchair
propulsion in manual wheelchair users (MWUs) with spinal cord injury (SCI) and
able-bodied individuals;
(2) to compare ultrasonographic measures of AHD,
supraspinatus tendon thickness, and occupation ratio between MWUs with SCI with and without shoulder pain (rotator cuff [RC] tendinopathy) ;
and (3) to compare
these ultrasonographic measures between MWUs with SCI and able-bodied
individuals. DESIGN: Cross-sectional study. SETTING: Rehabilitation centers.
PARTICIPANTS: Three groups of participants (N=95; aged between 18 and 60y) were
recruited within a convenience sample: objective 1: 16 MWUs with SCI (mean age,
43+/-9y; height, 172+/-13 cm, weight, 84+/-10 kg) and 16 able-bodied individuals
(mean age, 28+/-9y; height, 176+/-11 cm, weight, 72+/-12 kg); objectives 2 and 3:
37 MWUs with SCI (17 with [mean age, 47+/-11y; height, 172+/-14 cm, weight,
68+/-11 kg] and 20 without [mean age, 45+/-10y; height, 172+/-15 cm, weight,
84+/-30 kg] RC tendinopathy) and 26 able-bodied individuals (mean age, 31+/-5y;
height, 175+/-12 cm; weight, 89+/-14 kg). INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: AHD, supraspinatus tendon thickness, and occupation ratio of
the supraspinatus tendon measured using ultrasound imaging systems. RESULTS: (1)
Excellent intra- and interrater reliability of AHD was obtained in each arm
position (intraclass correlation coefficient>.85); (2) MWUs without shoulder pain
have thicker tendon than do MWUs with RC tendinopathy; and (3) a significant
Group x Position interaction was found for AHD measures when comparing MWUs with
SCI with able-bodied individuals (greater AHD at the end of the push phase for
MWUs with SCI). A thicker tendon and a higher occupation ratio were also found in
MWUs with SCI than in able-bodied individuals. CONCLUSIONS: Ultrasonography is a
reliable technology to evaluate AHD in MWUs in shoulder positions linked to
wheelchair propulsion. Supraspinatus tendon thickness and occupation ratio of AHD
adequately discriminate between MWUs with SCI and able-bodied individuals. This shows that these ultrasonographic measures can be used in future studies of
populations with SCI to better understand the changes at the shoulder joint in MWUs.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS